Synergies in social protection: impacts of India’s MGNREGA and public distribution system on the health and nutrition of women and children

This paper examines whether participation in workfare and food grain subsidy programs in India
impacts health and nutritional status of women and children in participating households, using
short-term morbidity and body mass index (BMI) as indicators. Using the Indian Human Development
Survey (IHDS), a nationally representative panel data survey conducted in 2005 and 2012, we estimate
average treatment effects for participants using a semi-parametric differences-in-differences and a
regression-based DID using a sample matched on the propensity scores. We find that participation in
these programs lowers morbidity for women by upto 28%. We also find evidence, though statistically
weaker, that participation increases women’s BMI, at least in states implementing those programs well.
For children, we find generally positive impacts of household participation in these programs on their
BMI, however there is no robust evidence of any impact on their morbidity. Our results suggest that
social protection programs can operate synergistically and deliver positive impacts on children and
women’s nutrition or health, even though this is not their main objective. At the same time, the effects
are heterogeneous, confirming that benefits of programs are mediated by intrahousehold dynamics.